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BED SORES (PRESSURE SORES)-Treatment, Healing ,Cure and Prevention of Bed Sores

Bed sore is painful, often reddened area of degenerating, ulcerated skin caused by pressure and lack of movement, and worsened by exposure to urine or other irritating substances on the skin. Untreated bedsores can become seriously infected or gangrenous. Bedsores are a major problem for patients who are confined to bed or a wheelchair. They can be prevented by moving the patient frequently, changing bedding, and keeping the skin clean and dry. Also called a pressure sore, decubitus sore, or decubitus ulcer

 Bedsores can occur when a person is bedridden, unconscious, unable to sense pain, or immobile. Bedsores are ulcers that occur on areas of the skin that are under pressure from lying in bed, sitting in a wheelchair, and/or wearing a cast for a prolonged period of time.

 Bedsores most often develop on the skin over bony areas where there is little cushion between the bone and the skin. The majority of pressure sores develop on the lower part of the body, including over the tailbone and on the back along the spine, on the buttocks, and on the heels. Other commonly affected areas are the back of the head, the backs of the ears, the shoulders, elbows, and ankles, and between the knees where the legs rub together.

  STAGES

Reddened or darkened skin that will not turn white when firmly pressed

The skin is intact but shows a persistent pink or red area that does not turn white when you press it with your finger. The wound may look like a mild sunburn. The affected skin may be tender, painful or itchy. It may feel warm, spongy or firm to the touch.

 Partial skin loss that may appear as an abrasion, blister or shallow crater:

The skin starts to breakdown and there is partial thickness skin loss. The wound looks like an abrasion, a blister (broken or unbroken) or a shallow crater.

Full skin loss extending to underlying tissue:

The skin has broken down and the wound now extends through all layers of the skin. The ulcer has become a crater involving damage or necrosis of subcutaneous tissues.

Full skin loss extending beyond the underlying tissue to muscle and bone

 There is full-thickness skin loss with extension beyond the deep fascia and involvement of muscle, underlying organs, bone, and tendon or joint space.

 Causes of Bed Sores

 A bedsore develops when blood supply to the skin is cut off for more than two to three hours. As the skin dies, the bedsore first starts as a red, painful area, which eventually turns purple. Left untreated, the skin can break open and become infected. A bedsore can become deep, extending into the muscle. Once a bedsore develops, it is often very slow to heal. Bedsores often occur in the buttocks area (on the sacrum or iliac crest), or on the heels of the feet.

 Symptoms of Bed Sores

Signs of infection in a bedsore can include:

 Pus draining from the sore

A foul smelling odor

Tenderness, heat and increased redness in the surrounding skin

Fever

 Diagnosis of Bed Sores

 In most cases, a doctor or nurse can diagnose a bedsore simply by examining the skin. Testing is usually unnecessary unless there are symptoms of infection.

 If a person with bedsores develops an infection, a doctor may order tests to find out if the infection has moved into the soft tissues, bones, bloodstream or to another site. Tests may include blood tests, a laboratory examination of tissue or secretions from the bedsore, and radiological tests to look for evidence of a bone infection called osteomyelitis. If you care for a family member who is confined to a bed or wheelchair, your doctor or home care nurse can teach you how to identify the earliest signs of bedsores. You'll learn which areas of skin are particularly vulnerable and what to look for. Once you know how to recognize the earliest signs of skin damage, you can take steps to prevent areas of redness from becoming full-blown ulcers.

 Treatment of Bed Sores

 It is important to treat bedsores as soon as they appear. If left untreated, the skin can break open and become infected. The treatment will depend on the severity of the sores and may include several methods. Treatment is more difficult if the skin is broken.

 Common treatments include:

 Removing pressure on the affected area

Protecting the wound with medicated gauze

Keeping the wound clean

Medication (antibiotics and pain relievers)

Antibiotic ointments

Surgical removal of dead tissue

Frequently and distributing body weight evenly with special mattresses or other support.

Washing a pressure sore daily with saline solution, which cleans and moistens the sore.

Providing a nutritional diet with adequate protein to promote healing.

Keeping unaffected tissue around a pressure sore clean and dry.

Removing dead tissue and applying medicated ointments or creams to reduce the risk of infection

 Prevention of Bed Sores

 Relieve pressure on vulnerable areas - Change the person's position every two hours when in bed and every hour when sitting in a chair. Use pillows to raise the person's arms, legs, buttocks and hips. Relieve pressure on the back with an egg-crate foam mattress, a water mattress or a sheepskin .

Reduce shear and friction - Avoid dragging the person across the bed sheets. Either lift the person or have the person use an overhead trapeze to briefly raise his or her body. Keep the bed free from crumbs and other particles that can rub and irritate the skin. Wash the person gently. Avoid rubbing or scrubbing the skin.

 Inspect the person's skin at least once each day - Early detection can prevent stage I redness from becoming worse.

 Encourage the person to eat well - The diet should include enough calories, protein, calcium, and zinc and vitamins C and E. If the person cannot eat enough food, ask your doctor about nutritional supplements.

 Encourage daily exercise - Exercise increases blood flow and speeds healing. In many cases, even bedridden people can do stretches and simple exercises.

 Keep the skin clean and dry - Clean the skin with saline (a non-irritating salt solution) rather than harsh soaps. Use absorbent pads to draw moisture away from vulnerable areas. If the person is incontinent, ask your doctor about ways to control or limit the leakage of urine or feces.

Use pillows to protect the common pressure points, which are under the heels and elbows and between the knees.

 Apply gentle massage with moisturizing lotion or cream to the back, arms, ears, hands, legs, and feet.

 If you are at great risk for skin breakdown, you may want to get a special "flotation" bed, which can be rented for home use.

 Risk Factors

 Diminished sensation or lack of feeling

 Heart problems

Incontinence (inability to control bladder or bowel movements)

Malnutrition

Obesity

Paralysis or immobility

Poor circulation

Immobility

Malnutrition and dehydration

Diseases and disorders that slow healing or lessen mental awareness

Diseases and disorders such as confusion or dementia that lessen mental awareness and may prevent a person from feeling the discomfort of a harmful body position

Medications, particularly sedatives

Care of Bed Sore

If an area of your skin is red or discolored but not broken, keep pressure off the sore, wash it gently with mild soap and water, dry thoroughly, and apply a protective wound dressing. If the sore doesn't heal in a week or two, if it recurs, or if you notice any broken skin or open sores, contact your doctor right away.

 Call The Doctor

 Get immediate medical care if you have signs of infection:

Fever,

 Drainage from the sore,

 A foul odor or increased heat,

 Redness in the surrounding skin.